DESCRIPTION: a. Candidate: Dr. Lisa Wheatley received her M.D. from Loyola University in Chicago in 1986 and trained in internal medicine at the University of Iowa. Following that, she served as a volunteer in India for six months and then trained in allergy and clinical immunology at the University of Pennsylvania, where she was a fellow. In 1994 she was appointed assistant professor in the Department of Internal Medicine at the University of Virginia. Her goal is to develop a new and independent research program at that institution. b. Sponsor: Dr. Thomas Platts-Mills is Professor of Medicine and Head, Division of Allergy and Clinical Immunology at the University of Virginia. c. Environment: The research will be carried out in the Division of Allergy and Clinical immunology at the University of Virginia Health Sciences Center. d. Training Plan: The project is based on the hypothesis that chronic sinusitis is an inflammatory and perhaps immunological disease. Chronic sinusitis was estimated in 1986 to be the most frequent chronic disease in the U.S., affecting over 30 million individuals. Dr. Wheatley proposes to investigate the role of IgG4 in chronic sinusitis by: (1) detecting, in serum, IgG4 that is specific for bacterial antigens commonly found in inflamed sinuses, (2) comparing the ratios of IgG4 and IgG1 to albumin in nasal washings and serum, (3) using RT-PCR to localize IgG4 mRNA in sinus tissue, and (4) using anti-CD40, coculture, and cytokines to examine B cell production of IgG4 without IgE. Dr. Wheatley will also investigate the role of Th2 responses in chronic sinusitis by measuring cytokine expression by bulk culture and cloned T cells isolated from inflamed sinuses and then comparing these responses to those for Th1 antigen and allergen.